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“We’ve known for months what it takes to bring Covid-19 under control. You need a period of severe lockdown to reduce the disease’s prevalence,” @paulkrugman writes. In fact, the solution might have been much simpler and easier: masks. (1/x) https://www.nytimes.com/2020/06/22/opinion/coronavirus-trump.html
In parts of the country, at certain stages, more would have been necessary: first guidance on social distancing and hygienic practice; where necessary, restrictions on first large gatherings; and in several places, perhaps, true lockdowns.
Everywhere, we should have aggressively moved to protect those we knew from the start were most vulnerable—chiefly, the elderly and especially those in nursing homes—as I wrote about here: https://nymag.com/intelligencer/2020/05/covid-targets-the-elderly-why-dont-our-prevention-efforts.html
But masks are not just an enormously powerful tool in the fight against covid, they are also extraordinarily cheap, compared to lockdowns. How effective are they? According to one study, in mask-wearing countries, the disease grew, this spring, 8% per week. In others, it was 54%.
Extrapolate those numbers over several weeks and they sketch disease trajectories so different they may as well be in different universes.
The science on these questions is not perfectly settled, of course, and other studies have found modest effects. On top of which, it can be hard to isolate the effect of masks when other cultural and policy factors contribute, as well.
But that masks have some meaningful positive effect was obvious from the start of the pandemic, because we knew at the outset that COVID-19 was a respiratory infection, and knew that masks were very useful and protective in fighting related diseases.
The brilliant @zeynep has been especially clear-eyed about this: https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html
I wrote my own assessment this past week, considering the effectiveness (and accuracy) of public-health guidance more generally through the early months of pandemic. The short version: it was not very good, veering wildly between complacency and alarm. https://nymag.com/intelligencer/2020/06/american-public-health-experts-coronavirus-masks.html
But the guidance on masks is especially distressing—as I write in the piece, "for all the love showered on Anthony Fauci, the failure to push mask-wearing when it might have really mattered may ultimately prove the most catastrophic misstep of the whole American response."
"In March, as evidence about the efficacy of masks began rolling in, Fauci was advising against them on 60 Minutes, in an effort to try and head off a possible mask run that would leave health workers undersupplied."
"Even Obama health-care adviser Ezekiel Emanuel, who recently touted a study showing several hundred thousand American cases were averted by mask-wearing, spent the winter insisting categorically that masks could not help."
In late April, Emanuel was saying that wearing masks should be as universal and expected as wearing seatbelts. But in February, he told Wolf Blitzer unequivocally, "It's not going to protect you." http://transcripts.cnn.com/TRANSCRIPTS/2002/29/se.01.html
In the winter, in the space of a few weeks, we went from hearing "the flu is worse" to entering into burdensome, near-universal national lockdown. We hadn't even tried mask-wearing or, really, any other less intrusive measures.
In some places, lockdowns at that point were necessary—New York most especially. But in most of the rest of the country, much smaller measures could have been suggested, if not even imposed, leaving lockdowns for when we needed them—now, in the case of, say, Arizona or Texas.
It is unfortunately the case, as @paulkrugman writes, that all of these measures have been politicized in ways both predictable and terrifying (both for our future management of this pandemic and our public-health prospects going forward).
And I can't argue with him, of course, when he writes, "this rejection of expertise, science and responsibility in general is killing us."
But when he points the finger more particularly at "a belligerent faction within our society that refuses to acknowledge inconvenient or uncomfortable facts, preferring to believe that experts are somehow conspiring against them..."
I think it's at least worth pointing out that, indeed, experts did conspire, in this instance, "massaging their messaging in the hope of producing a particular response from the public (and with the faith that they can expertly enough massage it to produce that outcome)."
When it comes to mask-wearing, the ultimate cost of that message-management may be tens of thousands of additional Americans lives lost. Perhaps more. (x/x)
